Organization
IHC HEALTH SERVICES INC
Active
Other names
Pacific States Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA C LECKMAN MD (CEO INTERMOUNTAIN MEDICAL GROUP)
(801) 442-3974
Entity
Organization
Contact information
Practice address
1401 E 2000 S, PROVO, UT 84606-2072
(801) 373-6910
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 373-6910
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
8082012
UT
Other
Enumeration date
05/21/2012
Last updated
05/21/2012
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